197608478-2-28-2024-29-AS-DPEA-D2WVWH-20240229154759

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608478
Report Date: 02/28/2024
Date Signed: 02/28/2024 03:31:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2022 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20221209151341

FACILITY NAME:	SUNRISE ASSISTED LIVING OF WOODLAND HILLS		FACILITY NUMBER:	197608478
ADMINISTRATOR:	PATRICE O'GRADY		FACILITY TYPE:	740
ADDRESS:	20461 VENTURA BLVD		TELEPHONE:	(818) 346-9046
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	127	CENSUS: 68	DATE:	02/28/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Patrice O'Grady		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff does not ensure that resident is appropriately dressed
Staff does not ensure that resident's hygiene needs are met
Facility staff did not complete an inventory of resident's personal items
Staff did not provide resident coffee in a sanitary manner
Staff did not adequately manage resident's behavior
Staff did not treat resident with dignity or respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to deliver final findings of the allegations listed above. During today’s visit, LPA met with Executive Director Patrice O'Grady and explained the reason for the visit.

On 12/12/2022, from 02:35 p.m. – 4:00 p.m., LPA initiated an unannounced complaint investigation for the allegations listed above. During the visit, LPA toured the physical plant, interviewed staff, and reviewed and obtained pertinent documents relevant to the investigation. Today LPA conducted a subsequent complaint visit toured physical plant, interviewed staff as well as reviewed and obtained copies of additional documentation relevant to the investigation.

It was reported that staff does not ensure that resident is appropriately dressed, as it was alleged that while on an outing, Resident #1 (R1)’s belt was not tightened properly and on a separate occasion was not dressed in clothes appropriate for the weather.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 4

Control Number 29-AS-20221209151341

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE ASSISTED LIVING OF WOODLAND HILLS	FACILITY NUMBER: 197608478
	VISIT DATE: 02/28/2024

NARRATIVE

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Continued from 9099
Interviews conducted with twelve (12) staff revealed that all (12) staff have never observed R1's belt appear to not be tightened properly. Each staff has also observed R1 to be dressed appropriately such as wearing multiple layers while outside the facility when the temperature was cooler or wearing thin layers while inside the facility when the temperature is warmer. LPA's interview with eight (8) family members / responsible parties of residents currently in care revealed that all eight (8) did not express any potential or immediate concerns that staff would not dress residents appropriately or properly. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff does not ensure that resident is appropriately dressed” is deemed Unsubstantiated at this time.

It was reported that Staff does not ensure that resident's hygiene needs are met, as it was alleged that staff were not ensuring R1 was showered in a timely manner. LPA’s records review reflected that R1 needed (2) person assist with showers, showered at least twice a week with assistance from Hospice, and was also showered upon request or when it was necessary. Records review of daily progress notes further revealed there did not appear to be any instances of R1 refusing to shower. LPA's interview with (12) twelve staff revealed that all (12) staff have observed R1 appear to be well kept, clean and each staff interviewed did not associate any foul odor with R1. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff does not ensure that resident's hygiene needs are met” is deemed Unsubstantiated at this time.

It was reported that Facility staff did not complete an inventory of R1's personal items, as it was alleged that at the time of admission an inventory of R1's personal items was never completed. Interviews conducted and records review reflected that R1's Resident Personal Property and Valuables (LIC 621) had indicated that the POA signed the form on 08/24/2022 and they did not want the facility to safeguard any of R1's personal items. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Facility staff did not complete an inventory of R1's personal items” is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20221209151341

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE ASSISTED LIVING OF WOODLAND HILLS	FACILITY NUMBER: 197608478
	VISIT DATE: 02/28/2024

NARRATIVE

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Continued from 9099-C
It was reported that Staff did not provide Resident coffee in a sanitary manner, as it was alleged that Staff #2 (S2) brought coffee to R1 and their POA in a dirty cup. Interviews conducted with twelve (12) staff revealed that all (12) stated that all dining ware is ran through the dishwasher after every use. When the facility had COVID positive cases then they would use disposable dining ware. Interview with S2 further revealed they do not recall having a conversation with R1's POA about a dirty coffee cup. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not provide Resident coffee in a sanitary manner” is deemed Unsubstantiated at this time.

It was reported that staff did not adequately manage resident's behavior, as it was alleged that a resident yelled and spoke inappropriately to R1 and the POA. Interviews conducted and records review reflected that while R1 was participating in an activity with other residents in care, R1 was being disruptive to the other residents participating by singing and making loud noises and R1 was told to “Shut Up” by Resident #2 (R2). LPA’s interview conducted with Executive Director Patrice O’Grady revealed that staff quickly intervened and both residents were spoken to privately about respecting. LPA’s interview with twelve (12) staff revealed that all (12) have never observed R2 yell or speak inappropriately to other residents since that incident occurred. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not adequately manage resident's behavior" is deemed Unsubstantiated at this time.

It was reported that Staff did not treat resident with dignity or respect, as it was alleged that Staff made a degrading joke about R1. Interviews conducted with twelve (12) staff revealed that all (12) staff have never observed any staff make a degrading joke towards a resident. All (12) continued to state they have always observed all staff to treat each resident with dignity and respect. LPA's interview with eight (8) family members / responsible parties of residents currently in care revealed that all eight (8) did not express any potential or immediate concerns that staff did not treat residents with dignity or respect at this time. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 29-AS-20221209151341

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNRISE ASSISTED LIVING OF WOODLAND HILLS	FACILITY NUMBER: 197608478
	VISIT DATE: 02/28/2024

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Continued from 9099-C Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “Staff did not treat resident with dignity or respect" is deemed Unsubstantiated at this time. Exit interview conducted/No citations issues/ A copy of report was provided.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 4